June 23, 2024

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The Supreme Court refuses to compensate 135 thousand euros to a woman with cancer for concealing her health condition

The Supreme Court refuses to compensate 135 thousand euros to a woman with cancer for concealing her health condition

Woman in hospital bed (Freepik)

he supreme court It issued a ruling denying compensation of 135,000 euros from the insurance policy of a woman who contracted the disease breast cancer. The reason behind this decision is that he concealed information relevant to his health condition at the time of signing the contract.

The case had a long history with contradictory rulings. The woman signed a life and disability insurance policy with Seguros RGA on June 6, 2011 and just days later, on June 21, 2011, she was diagnosed with breast cancer. For this reason, the insurance policy was rejected and a lawsuit was filed against the insurance company..

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The woman died, but her children continued the struggle. Court of First Instance No. 2 of Mandalorejo The claim was rejected, because it was considered that there was bad faith By the woman by failing to report important medical history and tests before signing the policy in a ruling dated January 15, 2019.

In this regard, they filed an appeal which was accepted by the Regional Court of Mérida, overturning the decision of the court of first instance and convicting Seguros RGA of high treason. Pay the insurance amount. Now the final decision has been taken by the Supreme Court as the lower court ruled in his favour.

the Supreme Court Chamber He decided that the insured did not provide truthful information about the health model. Although he indicated that he only carried out regular reviews, he did not mention the latter Mammography It was carried out on the same day as the contract was signed, which provided an initial diagnosis of the condition 70% of women with breast cancer. Three days later, a biopsy confirmed advanced-stage cancer.

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The court argued that the insured had knowingly and seriously breached his duty to declare the risk, according to Article 10 of the Insurance Contracts Law (LCS). According to the Supreme Court, the fact that the relevant medical history was concealed significantly influenced the insurer’s risk assessment.

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The ruling also refers to various previous rulings, such as 72/2016 and 726/2016, which highlight similar issues around the importance of truthful information in the insurance contracting process. “A person waiting for a clinical test to confirm or rule out the disease in question willfully violates his duty to declare the risk if he states that he does not have any health problem. At the same time, it silences relevant and indisputable precedents.

Finally, the Supreme Court decided that imposing costs of appeal was not appropriate, but ordered that the costs of appeal be borne by the Claimants. The decision concludes as follows: “The appeal of RGA Rural Vida SA de Seguros y Reaseguros is upheld and The plaintiff’s appeal was dismissed. It does not expressly impose costs arising from the appeal. “Obligating the plaintiff to pay the costs of the appeal.”

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